尿RBP与成人原发性肾病综合征的激素敏感性

摘要

Objective　To clarify the relationship between the renal tubular funciton and the efficacy of glucocorticoid, in adult patients with primary nephrotic syndrome. Methods　Pro-and post-therapy urinary RBP and NAG were determined double antibodies sandwich ELISA and color comparimetry with p-nitrate reductase, respectively. in eighty adult patients with primary nephritic syndrome, according to the concentrations of urinary protein, these patients were divided into three no remission group, partial remission group and fully remission group, fifty-one normal persons as control group. Renal tubular function parameters among groups were compared before and after therapy, and the results were analysed when those parameters were used to predict the sensibility of glucocorticoid therapy. Results　①There were no signivicant differences in urinary RBP, NAG and protein levels before treatment among patient groups (P>0.05); ②There were significant decreases in urinary RBP and NAG following glucocorticoid therapy in those response to glucocorticoid (P<0.01); ③There were significant differeces in urinary protein, RBP and NAG among three groups of patients with primary nephrotic syndrome after treatment. Conclusion　Determination of urinary RBP may predict the sensibility of the therapy in the adult patients with primary nephrotic syndrome and its diagnostic efficiency is better than urinary NAG.%目的:通过测定成人原发性肾病综合征患者尿RBP和NAG，了解患者肾小管功能与肾病综合征激素治疗效果之间的关系。方法：测定成人原发性肾病综合征患者治疗前和激素治疗8周后尿RBP和NAG含量，根据治疗后尿蛋白水平将患者分为未缓解、部分缓解和完全缓解3组并与正常人作为对照，比较各组间治疗前后肾小管功能指标变化。结果：①各病例组间治疗前尿RBP，NAG和蛋白质水平差异无显著(P>0.05)；②激素治疗有效者，尿中RBP和NAG明显降低，与治疗前比较，差异有显著性(P<0.01)；③三组肾病综合征患者之间治疗后尿蛋白、RBP和NAG比较，差异有显著性(P<0.01)。结论：尿RBP可预测成人原发性肾病综合征患者激素敏感性，且效果优于NAG。